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Baumeister: Vote for Biden’s Fix of ACA, Not Unsellable Medicare for All

Dave Baumeister, DFP columnist
Dave Baumeister, DFP columnist

DFP columnist Dave Baumeister questions the electability of candidates who shoot big on universal healthcare and recommends the more pragmatic approach of restoring the proven Affordable Care Act.

Greetings, Blogophiles!

This week. I saw a post from a friend on Facebook regarding Medicare for All, or M4A, as she writes.

It does seem like much of what we have been hearing lately concerning the Democratic presidential candidates is tied in with this concept. And my Facebook friend is a big Bernie Sanders supporter. In fact, she was also a big Sanders supporter in 2016, too.

Now, I have nothing against Sen. Sanders, as I think he would make a fine President. I voted for him in 2016, but I had much less to choose from.

Like many, I thought the nomination was stolen from him by Debbie Wasserman-Schultz, the superdelegates and the DNC, who all essentially handed the Presidency to Donald Trump by foisting an unlikeable candidate on the rest of America.

Sanders would have won the Electoral College and the popular vote in a landslide. And I believe there is a cadre of people around who still support Sanders for this reason.

But to me, as a voter, I don’t think the Bernie Sanders we have now is the same as the one as we saw in 2016.

That guy was so likable he had birds landing on his podium at rallies.

Now, I suggest that you find Sanders giving a speech at a rally or during a debate on TV, turn down the sound, watch the man on the screen and imagine all you are hearing, over and over, is “Hey, you kids, get off of my lawn!!”

But I give him credit that he was the one that brought Medicare for All into the forefront of the campaign (although I remember George McGovern bringing this up long ago).

My point? The thought of M4A has been around a long time, and the best we have is the Affordable Care Act, which has been greatly watered down by Trump.

So, let me get back to my friend. In that recent post, she talks about not being able to take early retirement from work because she and her family need the insurance.

She is on the state retirement system, so it allows for a person to get full retirement benefits once they have been in the SDRS 30 years and their combined years of work and their age equals 85.

However, when she looks at insurance, she is not eligible for Medicare until age 65. I would guess she is around 57.

She is right. M4A would cover her right away and allow her to retire, but just electing Bernie Sanders or Elizabeth Warren does not mean this would automatically take effect.

What are the chances Medicare for All will even become law in the next eight years, especially if Warren or Sanders would be elected President, and their states elect Republicans to replace them (Both Vermont and Massachusetts currently have Republican governors, so having a Democrat in the Senate is not a foregone conclusion).

I am not going to advocate for Joe Biden or any other candidate here, but I will advocate for Biden’s plan to rebuild the ACA.

Any person in the President’s office can do this. Remember, most of what Trump did to gut the ACA was done by executive order. The next President can change all of that back with the stroke of a pen on the same day that he or she takes the oath.

Then my friend could look at buying into an ACA exchange to get her insurance at a much more affordable cost and continue with her pre-65 retirement plans.

Bernie Sanders and Elizabeth Warren can do this, too, but if they are so hell bent for election on their M4A plans – and ONLY their M4A plans – they will be less likely to do anything that may keep those plans from happening.

I think total universal health care in this country would be a great thing, and, no doubt, someday it will happen. The ACA was a first step toward that.

But if I were worried about retirement before age 65 (and I am 61 now), I would be looking at the plan which would help me now, as opposed to one that would probably never be enacted in time to help me.

And now, I need to look at something else. My current insurance policy. I am planning to support whoever gets the Democratic nomination for President, as long as that person isn’t from New York City (Wasserman-Schultz, Hillary Clinton and Donald Trump, all from NYC, have given us the White House situation we have today).

I will never need M4A, because it won’t exist before I am 65. I don’t need Obamacare, because my current insurance is better.

But most of the people where I work are younger than me. We do not pay anything for our single policies, and our deductible is less than what the deductible currently is under Medicare.

So why would they vote for a person who hinges his and her campaigns to replacing our insurance with something more expensive?

The simple answer is that most probably won’t.


  1. Porter Lansing 2019-11-16 10:21

    Medicare begins at 66 not 65. I know, because my mailbox is loaded every day with Medicare supplemental offers for myself and my late wife. I turned 66 a month ago and have been on Medicare for fifteen years, already and she’s fully healthy forever, in Heaven. :) Apparently all these company’s research doesn’t know that. But like Big Macs, it’s probably cheaper to send every 66 year old the literature than to selectively leave out those who don’t qualify. (*It’s cheaper to make a big Mac with pickles than to leave them off, for special orders. It’s cheaper for a cable TV company to give you a package with channels you don’t watch, than to itemize. It’s cheaper for health insurance to include maternity for males than to sell you only what’s pertinent. It’s true. Ask an actuary.)
    ~ Anyway. It’s pronounced Boot-Edge-Edge and he’s the one with the public option that we’ve needed since Obamacare had to sacrifice it to get passed. Most of America likes their insurance.
    Making them change is not a winning plank.

  2. mike from iowa 2019-11-16 10:49

    Medicare started for me at age 58 when I was designated permanently disabled. Then they told me I would go on SS at age 62 and then when I turned 66 they told me they were taking me off disability and putting me on SS.

    Wingnuts have damaged ACA so badly it may be cheaper to discard it and start anew, first by banning wingnuts so they don’t have to endure moar lies about health care.

  3. jerry 2019-11-16 11:59

    Biden is mothered up too much with the bankers. Wall Street can make more money without the ACA so therefore, they hate the ACA. Biden was always timid about the ACA, so if president, I would look to see things more or less, the way they now are.

    “At one point, the same official said, Biden directly addressed the few advisers who were more enthusiastic about the health care endeavor, warning them that they did not understand the dangers and likely tradeoffs: “It was just, ‘We shouldn’t do this. This will be terrible for us. I know politics, I know people, I’ve been doing this for 36 years. You are all well-intentioned, but you don’t get it.’”

    The meaning and significance of these recollections are open to interpretation. Health care was not an issue on which Biden had particular expertise, and during the administration’s first year he was preoccupied with managing the 2009 economic stimulus package known as the Recovery Act, among other things.”

    Max Baucus got the Biden tirade very well and did all in his power to water the ACA down to the point that Chubby and the little monsters, keep pecking away at it even as this is being written. If Chubby wins, count on the South Dakota supported elimination of the ACA in Texas, to be the law of the land. Medicare for all is just a flash in the pan right now and is meaningless with this thing hanging over our heads.

  4. Miata Blue 2019-11-16 14:35

    Bernie Sanders wrote a bill that capitalized on the 2018 election win where Health care was the number one issue. Many new members of the House were elected by focusing on this issue and the idea of a comprehensive legislative solution to our current health sure looked like a winner. After all, the US system is the most expensive in the world with lousy outcomes. No one who gets sick likes their health insurance. Co-pays, deductibles, cost sharing, etc. add to the cost of private insurance all the while these plans become ever more restrictive in the applications of “network” doctors and hospitals. Those without insurance or who are under insured are dumped on emergency rooms where the tax payer ends up footing the bill. On top of all this is a prescription drug cost catastrophe that continues unabated.
    There is a lot of work to do on healthcare.
    In this environment Bernie Sanders took the opportunity to write his Medicare for All bill. In this bill is a singular act of political malfeasance of monumental proportions, outlawing private health insurance. Anyone who ever watched a John Wayne movie knows that you cannot walk in and outlaw something Americans already have. There is no way this will ever be accepted by the voting public.
    The shame of all this is that several politicians signed on to the bill (by all evidence) without reading the bill or without understanding the consequences. I would argue that the Kamala Harris campaign was terminally wounded by her first championing the bill and then backtracking once the challenge became clear. Warren has some of the same problem, she has been an ardent support of M4A; however, now finds herself being forced to backtrack much to her detriment. The damage done to the healthcare debate is huge.
    America really needs universal healthcare. It is the only path forward that will control costs and increase favorable outcomes. We need a rigorous debate on how to accomplish universal healthcare as there are multiple routes to be followed that will get us there. All the candidates would be well advised to focus on costs, outcomes, universal healthcare while discarding M4A. While there are many issues to be debated that all Americans are concerned about; such as, infrastructure, income inequality, deficit spending, foreign affairs and the Pentagon budget they all are being consumed by the continuous news feed driven by Medicare for All.
    We can elect a progressive democrat President who will work for all of us. A President who will represent us in good faith around the World and make us proud again. But I fear we cannot elect a President who is all in for Medicare for All.

  5. bearcreekbat 2019-11-16 15:06

    It seems quite incorrect to think “We do not pay anything for our single policies. . . .” Employer provided insurance is expensive and has to be paid for somehow. It seems much more likely that most, if not all, employers pay for this insurance with money that could and perhaps would otherwise go toward higher wages or salaries. After all, insurance benefits are offered as part of a wage package to attract employees. If that need disappeared employers would need to offer a different benefit to be competitive. It seems a bit naive or short-sighted to claim an employee somehow does “not pay anything” for insurance when, in reality, the employee is indirectly paying the entire cost through lower wages.

    As for analysis that focuses only on me, me, and me and whether I think I might personally be better off without Medicare for all regardless of how others are benefited, this type of evaluation seems a bit Trumpy.

  6. Donald Pay 2019-11-16 15:20

    Medicare for All is an aspirational program for many. I’m for covering everyone, but I’m not wedded to anyone’s program. Medicare for All or a similar single payer system would be my first choice if I was dictator, but neither I nor anyone else can be elected President with that program in 2020. You would lose critical Rust Belt states, and lose the Electoral College. Even if you could get elected, it simply is not going to pass the Senate, unless there is a major Republican meltdown. So the question becomes, what’s the best program you can get under realistic political situations. I want to hear from candidates on the left, what are their backup plans to M4A. What are they willing to accept in the real world?

    I can understand M4A as aspiration or a negotiating position, but as an election position or a viable plan for health care it just doesn’t make sense.

    I think a Democratic President would be able to shore up Obamacare. Some cost controls on many drugs through federal negotiation would probably be doable. A public option, which Obama couldn’t get done, should be sought, but that would be a stretch, unless it was combined with assistance for rural clinics/hospitals, provided Medicaid expansion occurred in that state.

    I’m not interested in someone giving me pie-in-the-sky plans that have no chance of being enacted. I’m all for Kennedy-like vision, but going to the moon was a hell of a lot easier than revamping health care.

  7. Debbo 2019-11-16 16:18

    I like this bit of smartassery:

    “Wingnuts have damaged ACA so badly it may be cheaper to discard it and start anew, first by banning wingnuts so they don’t have to endure moar lies about health care.”

    But seriously. I like Sen. Warren and I like universal health care, but ….. ACA with a public option is good too. That public option is really critical to make insurance companies behave.

    Sen. Warren has said that it would take some time to get her plan through and she doesn’t expect to get it done for 2-3 years. I suspect that may be optimistic. It mostly depends on the Senate.

    I think Buttigieg is okay, but not inspiring to me.

    Because I live in Minnesota, I have access more news items about Sen. Klobuchar. National publications keep saying we should keep an eye on her because she is an unapologetic moderate and Iowans seem to like her. The fact that Amy is a woman, Midwesterner, has a good life story and good rural connections are all big pluses because Democrats don’t want to elect another white man.

    I think Amy is highly electable. She’d do well with the Black vote, though not outstanding. Women would flock to the polls. Amy would probably do better in the Rust Belt/Midwest than any other Democratic candidate, and she might pick up a rural state or two.

  8. jerry 2019-11-16 16:57

    The sweet spot age of Chubby supporters is in the bracket just before Medicare. This is also the age where they are croaking the fastest due to no healthcare. Medicaid Expansion, part of the original ACA, was designed to provide coverage for them and all others. In South Dakota, 15,000 of our fellow citizens have died too damn early because of the failure of crooked republicans. So Medicare for all is just an argumentative approach that will probably not ever happen. Medicaid Expansion is where we should be going as that is already on the books. Crooked legislators must be voted out of our state and replaced with those who will save lives.

    “The Center on Budget and Policy Priorities reports on a new study of all the states in the nation, demonstrating that those that took Medicaid expansion “saved the lives of at least 19,200 adults aged 55 to 64 over the four-year period from 2014 to 2017.” The flip side is that 15,600 older adults died prematurely in the states that didn’t accept the expansion in those years.

    Following on other studies which have found that more low-income adults in Medicaid expansion states have used medication to control chronic conditions like heart disease and diabetes, researchers at the University of Michigan, National Institutes of Health, Census Bureau, and University of California Los Angeles have found clear evidence of a drop in mortality from these kinds of chronic conditions. The researchers focused on the group of pre-Medicare older Americans who have higher mortality rates and have a greater risk of premature death from treatable conditions. Using this group, they constructed a “novel data set that links the American Community Survey—the largest federal survey with information on income, age, and other determinants of Medicaid eligibility—with administrative death records. The large sample lets them detect small changes in mortality that aren’t evident in other data.” It also reaches a threshold that makes it statistically significant.”

  9. Debbo 2019-11-16 17:14

    Wow! That’s so damning! Excellent research Jerry. SDGOP is letting South Dakotans die. How cruel. Is anyone going to get that in a newspaper or other media? Maybe an LTE?

  10. bearcreekbat 2019-11-16 18:57

    I would speculate that it is a reasonable assumption (I haven’t seen the statistics) that people a bit older, say between 50 and 64, not yet eligible for Medicare, and least able to afford private insurance with a lower earning capacity due to less rather than more education (hence they would have qualified for Medicaid under an expansion), made up a substantial portion, if not majority of people dying or otherwise hurt because they happen to live in Republican States like SD that declined the Medicaid expansion.

    Indeed, statistics indicate that 69.5% of folks between 55 and 64 suffer from one or more chronic medical conditions.

    If these make up a substantial part of the people that have died in States like SD because of the refusal to expand Medicaid, there is a certain political irony for anti-Medicaid expansion Republicans. It has been reported that:

    Pew also found in their study conducted in April and May 2016 that warmth toward Trump increased with age, and coldness toward him decreased. . . . 60 percent of those aged 50 to 64 [felt warmly toward Trump] . . . .

    . . . Trump’s popularity was also consistently greater among those with lower levels of formal education. Back in the primary season, when Pew surveyed Republican voters and asked them which candidates they preferred, Trump’s ratings were highest among those who had not attained a college degree. This trend remained consistent when Pew surveyed Republican voters again in March 2016 and revealed that his popularity was highest among those whose highest degree was a high school diploma. . . .

    Makes one wonder if Trump and his Republican synchophants lost a substantial number of voters from the deaths of low income, poorly educated folks age 50 to 64 in those Medicaid non-expansion States.

  11. Porter Lansing 2019-11-16 19:14

    Buttigieg busts out to first place in Iowa
    Published: 11/16/19 08:06 PM EST
    Pete Buttigieg has surged to the top of the field in Iowa, according to the state’s flagship poll released Saturday.

    A Des Moines Register/CNN/Mediacom survey shows Buttigieg with 25 percent, followed by three candidates vying for second: Elizabeth Warren at 16 percent, and Joe Biden and Bernie Sanders at 15 percent.

  12. Porter Lansing 2019-11-16 19:49

    Universal health coverage has most often been adopted by a nation after a massive disaster. England after WWII was a pile of rubble. Nazi’s bombed the hospitals. Doctors were coming home to nothing. The only sustainable and affordable choice was National Health. It was a need, not a want. Hoping that’s not what eventually moves America to the change.

  13. Jebediah 2019-11-16 20:36

    Here’s a vague take anyone with any imagination and more knowledge than me can build on and refine to a successful end:

    Save tax money by ending imperialism, decrease costs by both removing the unnecessary part of society known as insurance and controlling health care material (drugs, equipment, etc) prices, tax at much higher levels the lazy rich who do little more than make money off their inheritances/labor exploitation/offshore accounts/policy manipulation/etc, and then pay for all health care with tax dollars. If necessary in this fascist land, we could make health care the new military-industrial complex, hire Hollywood and prominent news sources to replace terrorists/regimes/etc with diseases/injuries/cancers/etc, parade the strong and disciplined doctors/nurses/administrators all over sports games and parades, and call it “defense-against-poor-health spending”.

  14. Clyde 2019-11-17 07:28

    Well it’s pretty evident that Sanders doesn’t stand a chance.

    The corporate propaganda machine has done it’s job on this bunch. That along with daily evidence from my limited exposure to the propaganda machine that is doing their best to make sure no one even knows he still exist’s or is making him out to be that dirty old man telling kids to get off his lawn. Yep, if you folks are evidence we might as well give up any hope for this country!

    The Democratic party is doing their best as well with this farce of an impeachment. Apparently all senators will be tied up with having to be involved with this rather than being out on the campaign trail. Sanders and Warren aren’t going to be out pressing the flesh till primary time! I’d say that is a pretty good blow to a progressive hopeful.

    The so called “public option” will allow big insurance to “cherry pick” the healthy away from such a plan to the point that it will be useless! Get you head out!

    Something like 70% of citizens polled want medicare for all yet all you folks have been convinced that it CAN NOT work. The propaganda machine puppets strung up to corporate america are effective.

    Every advanced country in the world has public health care but we can’t have it! Oh sure, we don’t want it because those people are all dying from their poor health care! Look at the statistic’s! They are all healthier than we are! Even though our cost’s are many times greater and the outcome worse. Plus the fact that we are paying for it out of our pockets personally!

    Three of my acquaintances dead because they didn’t think they could afford to go to a doctor!
    This country is so effed!!!!

  15. Jenny 2019-11-17 07:51

    Like button for Clyde. This country could easily afford Medicare for All, but because the corporate elite 1% make the rules, it will not be done. So, Americans will continue to struggle and die from lack of healthcare and go bankrupt in the so-called richest country in the world.
    It is hard to be a working class person in a for profit corporate country where Washington doesn’t give a rat’s ass about you. Americans are not happy, suicide rates are rising, the cost of housing is out of control, obesity rates are embarrassing, the military budget is over bloated, guns are killing innocent kids in our schools, human trafficking is everywhere – but hey it’s okay because god darn it we’re the greatest country ever in the world they want us to say. Wrap that flag around me! We have Trump!

  16. mike from iowa 2019-11-17 08:30

    I am shocked some people worry more about campaigning than the future of the United States as a Democracy. What good does campaigning do for Dems when wingnuts have been stealing votes and elections, the courts and the WH for years? As long as this wingnut pestilence is allowed to flourish, America will never be the country we once aspired to be.

  17. Clyde 2019-11-17 09:09

    Lets see how well our current healthcare system work’s.

    We have a friend who is paying over 20K a year for health insurance that has a 10K deductible and limits her and her husband to care in a very small part of eastern South Dakota. She doesn’t want Med for all because they are afraid their taxes will go up! ???????????

    Another friend with a son that has always been single and is in his late thirty’s. He has major health problem’s that include being legally blind. In good ol So Dak they are playing hell trying to get him on title 19 so that he could be eligible for Medicaid.

    Great system we have!

    My dad used to say that people can get used to hanging if they hang long enough. Never thought that made much sense but I got the point. We have gotten used to hanging so we just need to hang some more.

  18. cibvet 2019-11-17 11:30

    My neighbor actually made the statement that if Obamacare hadn’t passed, that today we would have a great health care plan from the repubs.I think I annoyed him when I said that Santa and and the Easter bunny were also figments of his imagination.( and yes, he chugged his,my beer and went home) I only bring this up as an example of the mindset of trumpists.

  19. mike from iowa 2019-11-17 11:35

    Tis truly a wonder wingnuts don’t get tired off the lies wingnut pols them. There has been 10 years of wingnut promises to repel/replace the ACA with a better plan and they have nothing to show for a plan. Drumpf promised a great new plan as soon as he is reelected.

    Hope springs eternal, or is that just from being brainwashed?

  20. jerry 2019-11-17 11:45

    Chubby went to the hospital for “phase one” of his physical. Chubby likes the wording of “phase one” and uses it for almost everything… Maybe Chubby will be like Sean Duffy, the Chubby fluffer from Wisconsin who retired from Congress so he could go on the ACA to take care of one of his kids. So then, when is Chubby gonna put that cheap health plan that he, EB5 Rounds and Stretch all were saying we would have by now, why are they bogarting.

  21. Dave Baumeister 2019-11-17 12:11

    In the piece I wrote, I was not specifically talking against or for any one candidate. I was speaking to the simplest solution to health care in fixing the ACA. The candidates pushing Medicare for All should be realistic enough to do that. After that is restored, then they can look at making a universal Medicare for All, if they see there is still a need. There is nothing wrong with that. They can look at helping people in the short-term, and then maybe in the long-term, too. It took the country over 70 years to get from Medicare to Obamacare. I feel that candidates for President that are pushing something that has to be enacted by Congress, while ignoring what they can do right away, are just trying to pander to voters. Any one or all of the 67 people running for the Democratic nomination could still say, “I’d like to work to get the US to a ‘Medicare for All’ system, but the first thing I will do is bring back the parts of the ACA that Trump took away.” For anyone running for President to say, “Under my administration, we are going to have Medicare for All,” is no different than Trump saying, “We are going to have a beautiful healthcare system. The best healthcare ever!” Is it right for people to claim something will happen when they do not have control over making it happen? Of course not. If we had Medicare for All, my son, who has his own business, would probably like that and most likely have good insurance. As a parent, I would like to know he is taken care of in that regard. And thanks to the ACA I have that peace of mind, since I can keep him on my insurance for another 4 years.

  22. bearcreekbat 2019-11-17 12:24

    I have no knowledge of the individual circumstances or what the Title 19 Medicaid hold up might be for the individual Clyde describes as “legally blind,” but in South Dakota anyone who is in fact found to be “legally blind” and otherwise meets the Medicaid income and resource limitations is pretty much automatically eligible for Medicaid, with no further proof necessary.

    I think Clyde’s other friend that pays $20k a year for insurance is a concrete example of the explanation Elizabeth Warren repeatedly offers in response to the question of whether taxes must be increased to pay for Medicaid for all. Warren points out that under her plan even if Clyde’s friend’s taxes might increase, her total expense for health coverage will fall because she will no longer have to pay such huge private insurance premiums or such large deductables.

  23. Clyde 2019-11-17 12:50

    BCB, I don’t know all the logistics of what my friend is going through for her son but supposedly it would be easier for him to get on title 19 if he had been married and had dependent’s. As to the other friend, they are paying out a fortune and getting almost nothing in return IMO. Yet they think their taxes might go up enough that what they now have is a better deal! I can’t figure people out.

    Dave, is there anything wrong with the Medicare we now have? Sanders plan is to increase those on it by increments of 5 years at a time. Do you really think that expanding the ACA would be any easier to get through congress? I don’t think so but if some expansion is possible without holding up a move to Med for all that would be great. For those candidates saying we will get to Med for all someday it is pretty obvious they are only interested in kicking the can down the road a little longer.
    BTW, you should shop around for that insurance for your son. We found that it was cheaper to take the kids off our plan than to extend it. For us and the kid’s.

  24. mike from iowa 2019-11-17 15:28

    For those candidates saying we will get to Med for all someday it is pretty obvious they are only interested in kicking the can down the road a little longer.

    It is certainly possible candidates are thinking in terms of filibuster proof houses of congress in the next several elections. First, Dems have to retake the obstructionist Senate and then the WH. Then we can see where we are.

    As always, there will be a majority wingnut ideological judiciary, Moscow Mitch’s curse on America, to legislate from the bench in case wingnuts lose power as they rightly should.

  25. Old Spec.5 2019-11-17 16:16

    We need Clinton……………..a young Bill

  26. Caleb 2019-11-17 18:02

    I support Clyde emphasizing the propaganda machine, as from my perspective, most my fellow citizens appear to have an entirely inverted understanding of some very important history and our current situation.

    For instance, many fear socialism and communism without understanding either thanks largely to the CIA long ago convincing the world an international communist plot was bent on global hegemony through violence…when in fact the capitalists aimed at and effectively achieved such. A massive propaganda network has similarly shaped public consciousness relative to politics, economy, climate, etc. I mention this frustrated that many people still casually brandish their ideas of electability and political feasibility when possibly only radical change can address massive current and potential suffering around the globe.

    Aged 32, having spent relatively little time interfacing with them as fortunate health afforded my mind spending most time elsewhere, I know little about the health care and insurance systems. My most recent effort, though, was applying for coverage through This time the government succeeded verifying my identity (my last attempt was in 2015), so I have some results.

    The eligibility report says I earn too little money to qualify for free or low-cost insurance, something provided for those making 100-400% of the federal poverty level. 15 options stand before me, with the most affordable plan premium being 24.3% of my net monthly income and its deductible being 52.2% of my net annual income. My takeaway, which I acknowledge could be wholly incorrect, is that current insurance design is in general (much like money) a form of social control, one that persists through dominant narratives misrepresenting and demonizing the poor and generally distracting from severe inequality.

    Whenever our imagination and cooperation stops at our loved ones’ and acquaintences’ needs being met, we stray from developing a more egalitarian society, and all too often end up supporting something opposing one. Idealism can be pragmatism over a long term. Likewise, if we believe in an ideal, and take short-term actions side-stepping that, doing so can be pseudo-pragmatism applying a bandage over a wound that will outgrow it. I propose that instead of talking about who is electable and what is politically possible, we shape those things by ceaselessly putting pressure on those who so often are so casually shaping our lives while tens, hundreds, or thousands of physical miles (and often far more mental and emotional miles) apart from our needs and interests.

    I don’t know how to do that, so here are a couple links, of which my thoughts above reminded me, that might inspire some creativity:

  27. Clyde 2019-11-17 18:32

    Mike, didn’t we have a filibuster proof senate under Obama and it was frittered away? IMO, we also need the right person in the white house and to me that is Sanders. I see no one else out there right now that can lead on this front and many others. The power’s that be apparently agree since they are doing everything they can to make him go away. So, to me, we need the dems to have a landslide in both the senate and the house along with Sanders and Warren leading.

    Pipe dream, ain’t it!

  28. Richard Schriever 2019-11-17 18:40

    A question for ALL the commenters here’ How does the private health insurance industry benefit YOU – personally? By benefit – I mean ADD to your bottom line.

  29. mike from iowa 2019-11-17 18:45

    No Clyde, Dems had a filibuster proof senate for a total of four months of Obama’s first 2 years.
    Without having to re look up all the details, Sen Kennedy missed much of those years with major illness and then wingnuts won his seat in a special election. then Robert Byrd passed away, among other things.

  30. Porter Lansing 2019-11-17 19:05

    Obama never had a super majority. Al Franken’s win was contested and Alan Byrd was too sick to vote. We had to give up the public option to get Joe Lieberman’s vote.

  31. leslie 2019-11-17 20:12

    Crickets Clyde :)

  32. Debbo 2019-11-17 20:16

    Clyde, I like your pipe dream, except Warren rather than Sanders.

  33. jerry 2019-11-17 20:38

    Even When Chubby tries to do the right thing regarding healthcare, the Wall Street right wing will do all they can to crush it. The powers of the insurance and the hospitals, doctors, et al. will stop at nothing to keep the charade of America’s “great” healthcare from being seen as it is…a flippin failure.

    “WASHINGTON) — New rules from the Trump administration on Friday would require insurers and hospitals to disclose upfront the actual prices for common tests and procedures to promote competition and push down costs.

    The sweeping changes face stiff pushback from the health care industry and could be challenged in court. Even in an ideal world where information flows freely, patients and their families would have to deal with a learning curve to become comfortable with the intricacies of health care billing.

    “This shadowy system has to change,” Health and Human Services Secretary Alex Azar said. “The patient has to be in control.””

    Irony alert. Chubby wants everyone to be transparent…but Chubby. Still, we cannot have Medicare for all or anything, for that matter, without a Social Security type of healthcare. Universal healthcare or nothing. Offer private insurance to those who want to pay for it, but a Social Security universal healthcare for everyone else.

  34. Clyde 2019-11-18 07:27

    I thought Obama had a majority for longer than that but be that as it may even a majority of republican voters say they want med for all. A strong president able to rally the electorate ought to be able to shame or get a senator ousted that won’t go along with what the majority wants. Again, a pipe dream?
    IMO, the biggest problem would likely be with democrats and the corporate propaganda machine. Cory Booker killed Sanders bill to re-import drugs from Canada. Did the press make an issue of it??

  35. Porter Lansing 2019-11-18 08:36

    Mr. Baumeister & blog readers … Because South Dakota can’t be sold on Medicare For All means little. The majority in SD are known for extreme negativity bias and the state ranks in the bottom five states for innovation. Where the votes are (New York, California, Florida, and other liberal states) are what matter for any new idea. Bottom line is that the middle class will save money and the uber-wealthy will pay more for their opportunity to make money in the safest economic environment in the world.

  36. jerry 2019-11-18 08:42

    Warren tones down the Medicare for all to make the deal work. Booyah!

    “Warren was the lone candidate to still support the Sanders plan without any qualifications. But now she’s tacitly acknowledging Medicare-for-all’s political difficulty by proposing that people should be allowed — but not forced — to enroll in government health insurance as a first step toward universal health coverage.

    Under her proposal published Friday in a Medium post, Warren says in her presidency’s first 100 days she would push Congress to expand Medicare to people age 50 and older and create a Medicare-type plan anyone else could buy, subsidized more heavily than the private plans available in the Obamacare marketplaces. Democrats would have to win a majority in the Senate so they could use the budget reconciliation process, which would allow them to bypass Republican support.” Washington Post 11.18.19

    Now, this makes more sense to folks who worry about mandates and the consequences. BTW, even today, we are still seeing the consequences of George W. Bush’s Medicare drug Part D mandate to purchase. 2003 was a long time ago and seniors have either forgotten that they must buy a drug plan or pay the penalties…for as long as they live.

  37. Porter Lansing 2019-11-18 09:08

    Way to go, Liz! Therein lies a fundamental difference between Democratic and Republican Presidents. Dem’s can tweak a policy, midstream to improve performance. Repub’s stomp their feet and try to destroy the lives and careers of those that intelligently disagree with their plans.

  38. jerry 2019-11-18 09:25

    Meanwhile, Chubby chickens out with the vape ban. Addictive tobacco and its by products are what drives healthcare costs through the roof. “She’s got a son”, good one Chubby. I’m sure the kid appreciated the fact that he is now just an object to his old man’s attention, much like a gold plated crapper.

    ““We can’t have our kids be so affected,” Trump said a couple of months ago at a policy announcement with his wife. “She’s got a son,” Trump added, referring to their shared son, Barron. “She feels very strongly about it.”

    Trump was shaken by a pervasive social media campaign called #IVapeIVote and protesters at his rally. Campaign manager Brad Parscale reportedly told him that he could risk losing voters in the battleground states if he went through with the ban.”

    So here we go. Healthcare to republicans is all about the benjamins. They could care less about the public’s health or the costs involved.

  39. Chris S. 2019-11-18 12:51

    This is a prime example of why the Democratic Party in South Dakota is so moribund. A group of Savvy Realists looks wistfully to doddering Joe Biden to save us. For crying out loud, Biden ran his first failed presidential campaign way back when I was in high school and he was the plagiarizing Senator from MBNA. And to seal the deal, they clap and chant “Better Things Aren’t Possible! Vote for us!”

    Gee, it’s a mystery why the state Democratic Party can’t attract new members.

  40. Debbo 2019-11-18 13:38

    Good link Mike.
    Here’s a quote from Liar-in-Chief: “I will never allow these politicians to steal your health care and give it away to illegal immigrants.”

    1. He is a liar, so no one should believe this.
    2. He is very likely to steal health care, but he’ll shower the benefits, golden and otherwise, on himself and other wealthy scum. He has not one, single altruistic cell in his entire, lumbering body.

  41. Clyde 2019-11-18 18:25

    Jerry, to me, Warrens plan to tone down is the first step in giving away the farm. She has been willing to compromise to much in the past and Chubby made her look pretty silly over the “Pocahontas” thing. Don’t get me wrong, if she is the top of the ticket I will vote for her and hope for the best. I believe Sanders would be the better choice though because he wouldn’t compromise and would take the road blocks to task. I just believe he is the stronger candidate and apparently the corporate propaganda machine thinks so too. Constant negativity against Sanders while Warren seems OK. Just the way the system has been against Sanders puts him at number one for me.

  42. kj trailer trash 2019-11-18 19:10

    Medicare begins at 65, Porter, unless you’re for some reason eligible for it earlier. I’m not sure, but I believe a person has to sign up for new “Medigap” insurance every year, thus the constant ads from Joe Namath and others trying to sell us “Medicare Advantage” and other Medicare supplements this time of year. At least it drowns out the incontinence and catheter commercials on MeTV. (If and when I need catheters, I’ll figure out where to find them without being bombarded by ads for ones that “hurt less.” Shoot me, please, right before that happens.)
    Dave B., I don’t have a whole lot of time for those who work till 55 for 3M or the government or a small handful of other entities and then retire with a partial pension, which helps drive up the cost of products, or of government, for the rest of us. Either we all deserve early retirement or no one does. My friend who moved to 3M three months after we started at another factory is not more worthy than I am.
    This brings me to my main point about M4A: Basic human decency says that we support Medicare for All, or Universal Healthcare, or whatever you wish to call it. If we don’t want everyone to have equal access to affordable healthcare, with absolutely no fear of medical bankruptcy, then what in the living hell are we doing calling ourselves human beings? Never mind that it’d be cheaper, in the long run, for every single swingin’ American. What amazes me about the whole debate is that I’m NOT ALL THAT GREAT A PERSON (I’m a judgmental dick), yet I want everyone to be free from medical-debt-worry. This really points out to me the selfishness of a lot of Americans who are, in general, a lot better people than I am. “Oh, my company (currently) pays my premium and the deductibles aren’t so bad–why would I want that to change?” To be good and be fair, is why. And to fend off the inevitable, which is that every company eventually has to put some of the burden, or more of the burden, of health care premiums onto the employees, because of the current and future out-of-control medical costs in this country.

  43. Clyde 2019-11-18 20:15

    kj tt you get a thumbs up from me!

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